PEBC: Theme of the Week: Notable Drug-Food Interactions
In pharmacy school, we learn all about drug-drug interactions, but drug-food interactions are often missed. Some medications are taken with food, whereas some are on an empty stomach. Some even have specific diet restrictions. Here are five drug-food interactions that are important:
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1) Metronidazole: Patients taking this antibiotic must be counselled to avoid alcohol during treatment and 2 days after completion, as this would precipitate out a disulfiram-like reaction. This combination results in facial flushing and vomiting symptoms.
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2) Levodopa: A drug used for Parkinson’s Disease. Patients on levodopa should avoid taking it with a high protein meal because it can decrease its absorption. Protein competes with levodopa for transport into the bloodstream.
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3) Warfarin: Warfarin’s actions are countered by vitamin K. Patients should be advised to keep a constant vitamin K intake, especially from vegetables and fruits. A significant change in diet can lead to a change in anticoagulation.
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4) MAO Inhibitors (phenelzine, tranylcypromine): these antidepressants are famous for their ability to cause a hypertensive crisis. MAO inhibitors prevent the breakdown of tyramine, an amino acid, which can lead to an increase in blood pressure. Tyramine is found in foods such as aged cheese, kimchi, fava beans, cured meats and fermented beers.
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5) Contrave (bupropion/naltrexone): this combination for weight loss should not be taken with a high-fat meal because it can lead to an increased release of medication. This results in increased GI symptoms and seizure risk.
What other interesting drug-food interactions have you noticed in your day-to-day practice?
